中国骨质疏松杂志

99Tc-MDP治疗糖皮质激素诱导不同分期骨量减少的动物模型实验研究

Experimental study of 99Tc-MDP in the treatment of different stages of osteopenia induced by glucocorticoid in animal models

DOI：10.3969/j.issn.1006-7108.2013.10.006

中文关键词: 99Tc-MDP 骨量减少动物模型治疗

英文关键词:99Tc-MDP Osteopenia Animal model Treatment

基金项目:上海市黄浦区科委2010-2012年度科研基金（2010HCG-20）

作者	单位
梅小刚1 高克加1 徐明2 叶智卫1 周瑞明1	1.上海市黄浦区中心医院核医学科，上海200002，2.病理科

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中文摘要:

目的探讨不同程度糖皮质激素诱导骨量减少组动物模型经99Tc-MDP治疗后的疗效以及价值。方法采用肌肉注射地塞米松膦酸钠注射液（DX）诱导不同程度骨量减少的兔动物模型，兔49只，设计分为7组：正常对照组（A组）、临界骨量减少对照组（B组）、骨量减少对照组（D组）、骨质疏松对照组(F组)；临界骨量减少治疗组（C组）、骨量减少治疗组(E组)、骨质疏松治疗组(G组)；C、E、G 3组采用99Tc-MDP治疗16w；检测各组病理组织学、骨密度、核素显像ROI比值、X线和CT、血清骨碱性膦酸酶、骨钙素。统计应用SPSS13.0软件进行方差分析和组间T检验处理。结果各模型组B、D、F 与A组的骨密度、骨显像比值ROI、BALP、BGP组间比较存在统计差异：T值>2.179（P＜0.05）；骨密度（左股骨颈F=31.038、L4 F=13.069），骨显像比值ROI（股骨颈F=36.045、L4 F=47.435）（P＜0.05）；病理结果，A、B组正常；D组骨小梁排列欠规律，骨小梁变细；F组骨小梁排列不规律，分布稀疏，伴断裂现象。治疗组结果分析：C、E治疗组指标与A组比较，t值均<2.179（P>0.05）， G组与A比较大部分指标存在统计学差异（P＜0.05）；同时各模型组治疗前、后比较均有效果，其T值均>2.179（P＜0.05）；病理组织学切片显示：C组、E组的骨小梁接近于A组骨小梁分布；G组稀疏的骨小梁也有所改善。结论 99Tc-MDP治疗对不同程度的糖皮质激素诱导骨量减少都有治疗效果，尤其在临界期治疗效果明显。本实验在早期骨钙流失时的治疗效果明显，为临床早期发现和治疗骨量减少提供参考。

英文摘要:

Objective To explore the efficacy and value of 99Tc-MDP in the treatment of different stages of osteopenia induced by glucocorticoid in animal models. Methods Rabbit model with different statges of osteopenia were established using intramuscular injection of dexamethasone (DX). All the 49 rabbits were divided into 7 groups: the normal control group (Group A), the critical osteopenia in control group (Group B), the critical osteopenia therapy group (Group C), the osteopenia in control group (Group D), the osteopenia therapy group (Group E), the osteoporosis control group (Group F), and the osteoporosis therapy group (Group G). Rabbits in Group C, E, and G were treated with 99Tc-MDP for 16 weeks. Then the pathological histolody was observed. The bone mineral density, ROI, X-ray and CT scanning, BALP, and BGP were determined. A SPSS 13.0 software was used for variance analysis and t-test. Results The bone mineral density (the left femoral neck: F=31.038, L4: F=13.069, P<0.05), the ratio of bone imaging (the left femoral: F=36.045, L4: F=47.435, P<0.05) in Group B, D, and F were significantly different with those in Group A (T>2.179, P<0.05). The pathological results in Group A and B were normal. The trabeculae in Group D arranged irregularly and thin, while in Group F the trabeculae appeared irregular-arranged and sparse distribution and had fracture phenomenon. Analysis of results in treatment groups indicated that there was no statistical difference among Group C, E, and Group A (T<2.179, P>0.05), while significant difference between Group G and Group A was observed (P< 0.05). The difference between groups before and after the treatment was significant (T>2.179, P<0.05). Pathology study showed that the trabecular distribution and arrangement in Group C and E was close to Group A. And the sparse trabeculae in Group G also improved. Conclusion 99Tc-MDP is effective in the treatment of different stages of osteopenia in animal models, especially for early bone loss (the critical osteopenia period). The treatment shows obvious effect in the early loss of bone calcium, which provides clinical reference for early detection and treatment of bone mass loss.

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